Could it really all be stress/depression?

[FLNatalie]

I posted on here once before, but I just got the results of my MRI, so I'm updating:

I began having symptoms in early February which at first alarmed me, but which I quickly dismissed as being something benign. I was having trouble seeing in a vague sort of way and I had two days of numbness in my extremities and face. Then a month later, while the vision had deteriorated into double vision and an extreme sensitivity to light, the numbness returned. Since that time, I have experienced heat intolerance, confusion, random muscle weakness and fatigue, more and more numbness and other paresthesia symptoms (burning, tingling, electric-shock type feelings, etc.), and dizziness.

All of my vision and paresthesia symptoms generally get worse in the evenings.

My PCP referred me to a neurologist (an MS specialist), but I wasn't having any symptoms other than the vision issues at the time of the appointment. The neuro did all of the usual tests and said his level of suspicion for MS was low, but he could see that I was clearly concerned so he ordered an MRI and an SSEP. My PCP ordered bloodwork and referred me to an opthalmologist.

The bloodwork apparently came back "within normal limits, and the ophthalmologist said my optic nerves looked healthy, my vision was fine, and that she couldn't see anything that would explain why I have double vision. She even did a visual field test and an OCT scan with no negative results.

I had an MRI and an SSEP and saw my neurologist today to review the results. He said he saw *nothing* on the MRI and the SSEP was normal. He believes I am suffering from stress and anxiety and asked if I would like to take an antidepressant. I didn't answer right away, so he suggested a psychologist and to follow up again with him (the neuro) in a month if symptoms persist.

Do any of you know someone for whom all these kinds of symptoms have really turned out to be "just" stress. As surprised as I was to hear that from the doctor, it would be a big relief, if it were true.

[jimmylegs]

hi from my perspective, given that stress can certainly change physiological nutrient demand, yes physical symptoms can indeed be related to stress.

my old boss was told she was not able to get pregnant and was losing hair due to 'stress'. she had no child for a year and a half, and a shaved head for even longer. i told her to take zinc and magnesium and she was pregnant in six weeks' time. plus she was able to relax when she had previously thought she just had a high strung personality. and her hair grew back too. if you get basic essential nutrient tests done, they will come back low normal, but high normal is the level you'll see in healthy controls in research.

here's a short list of important serum nutrient targets, which i've likely already sent your direction but fwiw:

serum vitamin B12: aim for at least 370 pmol/L (500 pg/mL)
serum vitamin 25(OH)vitaminD3: aim for at least 100 nmol/L (40 ng/mL). preferably 125-150 nmol/L (56-60 ng/mL). ...
serum zinc: aim for 18.2-18.4 umol/L. (~120 ug/dL)
serum magnesium: aim for .95-1.1 mmol/L. (or 2.3-2.7 mg/dL)
serum copper: aim for 17.3-18 umol/L (or 100-114 ug/dL)

with these targets you can assess whether your diet and/or supplement regimen is hitting the mark. this way, if a symptom resolves you can cross check against levels (and if it doesn't but levels are confirmed optimal, you know to ask some new questions)

relevant reading:

Stress control and human nutrition
http://medical.med.tokushima-u.ac.jp/jm ... ion_detail

hope that helps!

[lyndacarol]

I think that stress is used too often as an excuse by a doctor who is unwilling to say, "I don't know the cause." (In the same way, "it must be a virus" is often used, I think.)

I encourage you to investigate a possible vitamin B12 deficiency (your symptoms are found in a list of B12 deficiency symptoms) – your PCP can start with simple blood tests (or maybe these have already been ordered?). By the way, ask for copies of your blood test results – get the actual numbers; don't settle for "within normal limits."

I am not in favor of casually-prescribed antidepressants. Be aware that many medications, including antidepressants, inactivate vitamin B12 stored in your body. Obviously, this would not be helpful if the underlying problem is with B12 to begin with.

[jimmylegs]

in studies they've also used magnesium depletion as an animal model to test pharma anti-depressant efficacy. brilliant 7:|

[FLNatalie]

I guess I'll have to see what I can do about the nutrient testing - none was ordered for me.

I know I pm'd you about that multivitamin I was taking, JL, but I had to stop. It was giving me migraines (pretty sure that was the cause, as I don't normally get them, and that day I took all 3 I got a REALLY bad one, then even on taking one, I was getting sharp pains in my head).

I might do better trying to zero on on where I'm low instead of taking a multi...

[lyndacarol]

MANY symptoms of B12 deficiency are the same as those symptoms of MS!

"Everything You Want Your Doctor to Know about Vitamin B12"



I highly recommend this 50-minute documentary from the filmmaker Elissa Leonard, featuring Sally Pacholok, RN, BSN & her husband Jeffrey Stuart, D.O. (authors of the book, Could It Be B12? An Epidemic of Misdiagnoses); Lawrence Solomon, M.D., hematologist with Yale Medical School; Ralph Green, M.D., hematologist at UC Davis; and Donald Jacobsen, PhD, at the Cleveland Clinic (Homocysteine Research Lab).

@1:23 "The neurological manifestations well precede the hematological manifestations."

@1:46 "In 1948 scientists isolated a red crystalline pigment and named it vitamin B12. It is a primordial molecule responsible for the health of all the DNA in all our cells. The Framingham Offspring Study suggests 40% of Americans have suboptimal B12."

RED FLAGS: stomach problems, food allergies, frequent infections, upper respiratory problems (pneumonia), nausea, weakness and falling, neuropathy, fatigue, clumsiness & loss of dexterity, loss of positional sense (Sub Acute Combined Degeneration Of the Spinal Cord).

RED FLAGS: toe dragging/steppage gait (foot drop), unsteadiness/loss of balance, Multiple System Atrophy (Olivo-ponto-cerebellar Atrophy), optic neuritis, hearing loss, speech problems, panic disorder, muscle wasting, temperature dysregulation, anorexia, diarrhea, malabsorption, anger & depression,

RED FLAGS: Swollen Tongue; Difficulty Eating (feeling full after a few bites); Brain Fog; Dizziness; Memory Impairment; Compulsive Behaviors; Delusions (bugs crawling on scalp); Bleeding Disorders/Low Platelets (Easy Bruising = ecchymosis); Fatigue; Pre-eclampsia; Pre-term labor; Premature Delivery of offspring; Congenital Heart Defect in offspring; Failure to Thrive in offspring Digestive Disturbances leading to surgery; Severe Mood Swings; Pulmonary Embolism; Essential Tremor & voice tremor; Tachycardia; Anxiety Attack/Disorder; Colitis (lymphocytic colitis); Malabsorption; Very Low Serum B12 (74); Stabbing Chest Pains.

Signs and Symptoms of B12 Deficiency:
Tingling/Numbness
Sore Mouth or Tongue
Fatigue
Anxiety
Irritability
Depression
Weakness
Abnormal Gait
Mental Impairment
Visual Disturbances
Migraine
Orthostatic Intolerance
Chest Pain
Tachycardia
Difficulty Breathing
Edema
Elevated Homocysteine
Elevated MMA
Stomach and G.I. Problems
Blood Abnormalities
Neurological Lesions
Limb Movement Disorders
Psychosis
Thoughts of Suicide

[jimmylegs]

yep sounds like you could do well to look at some specifics. with a multi it's entirely possible that the proportions of the ingredients could worsen an existing imbalance. given that you were sensitive to the multi, it does point to a nutritional imbalance of some kind being in the mix. if you can get those five tests above run, and get your own copy of results to compare to those targets, it would likely point up some handy next steps for diet and possibly specifics for supplements. one other thing.. i know you said they ran no nutrient tests recently. but remind me if you've had a serum ferritin test done in the past? if so, how was your status?

[kitINstLOUIS]

Which B12 symptoms are exclusive to B12 def.?

Would demyelinization cause a lot of overlap? Are there symptoms of MS that are not caused by B12 def.?

New symptoms, but have one MTHFR gene (heterogeneous). Can't help but wonder whether B12 treatment is ineffective even though serum levels increased from 220 pg/mM to over 800. May be problems in down-regulation at cellular level.

Severe muscle weakness, light emotional liability, eye pain but also have euthyroid Graves' disease 5 years post-thyroidectomy

[lyndacarol]

Which B12 symptoms are exclusive to B12 def.?

Would demyelinization cause a lot of overlap? Are there symptoms of MS that are not caused by B12 def.?

New symptoms, but have one MTHFR gene (heterogeneous). Can't help but wonder whether B12 treatment is ineffective even though serum levels increased from 220 pg/mM to over 800. May be problems in down-regulation at cellular level.

Severe muscle weakness, light emotional liability, eye pain but also have euthyroid Graves' disease 5 years post-thyroidectomy

Welcome to ThisIsMS, kitINstLOUIS.

In my opinion, there are no symptoms "exclusive" to B12 deficiency, other nutrient deficiencies, MS, Celiac Disease, or any other number of conditions. Any condition can choose one, many, or all their symptoms from the basket of symptoms.

Just as there is no one definitive test for MS, there are no definitive symptoms.

In investigating the one symptom of peripheral neuropathy, the University of Chicago suggests blood tests to rule out some of the many conditions manifesting with peripheral neuropathy:

http://peripheralneuropathycenter.uchic ... #bloodtest

Blood tests

Blood tests are commonly employed to check for vitamin deficiencies, toxic elements and evidence of an abnormal immune response.

Depending on your individual situation, your doctor may request certain laboratory tests to identify potentially treatable causes for neuropathy. These include tests for:
Vitamin B12 and folate levels
Thyroid, liver and kidney functions
Vasculitis evaluation
Oral glucose tolerance test
Antibodies to nerve components (e.g., anti-MAG antibody)
Antibodies related to celiac disease
Lyme disease
HIV/AIDS
Hepatitis C and B

I am not convinced that the focus on demyelination as the cause of MS symptoms is correct. At this time, like Dr. Terry Wahls (http://www.TerryWahls.com), I begin to think the root of the problem is in the mitochondria. B12 is at play in the cells.

Your postings sound to me as if you had B12 treatment for a while, but discontinued when the serum level increased to 800+ pg/mL; please correct my understanding if you continue taking B12 injections to this day. The serum levels testing may not give the real picture if the B12 problem is not one of absorption into the bloodstream, but occurs farther along in the metabolism in the cells. For some situations, lifelong B12 injections are necessary.